Local drug delivery for oral mucosal diseases: challenges and opportunities

• Published in: Oral diseases Vol. 17; no. s1; pp. 73 - 84
• Main Authors: Sankar, V, Hearnden, V, Hull, K, Juras, D Vidovic, Greenberg, MS, Kerr, AR, Lockhart, PB, Patton, LL, Porter, S, Thornhill, M
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2011; Wiley Subscription Services, Inc
• Subjects: Biological Factors - therapeutic use; Controlled release; Delayed-Action Preparations; Dentistry; Drug delivery; Drug Delivery Systems; Gene therapy; Genetic Therapy; Humans; Macromolecular Substances - therapeutic use; Macromolecules; Medical research; Molecular Targeted Therapy; Mouth Diseases - drug therapy; Mouth Mucosa - drug effects; Mouth Neoplasms - drug therapy; Mucosa; mucosal disease; Mucositis; Neuropathy; Oral cavity; oral mucosa; Salivary Gland Diseases - drug therapy; Side effects; Surface area; swallowing; Taste; trans-mucosal
• ISSN: 1354-523X; 1601-0825
• DOI: 10.1111/j.1601-0825.2011.01793.x

Oral Diseases (2011) 17 (Suppl. 1), 73–84 There are few topical formulations used for oral medicine applications most of which have been developed for the management of dermatological conditions. As such, numerous obstacles are faced when utilizing these preparations in the oral cavity, namely enzymatic degradation, taste, limited surface area, poor tissue penetration and accidental swallowing. In this review, we discuss common mucosal diseases such as oral cancer, mucositis, vesiculo‐erosive conditions, infections, neuropathic pain and salivary dysfunction, which could benefit from topical delivery systems designed specifically for the oral mucosa, which are capable of sustained release. Each condition requires distinct penetration and drug retention profiles in order to optimize treatment and minimize side effects. Local drug delivery may provide a more targeted and efficient drug‐delivery option than systemic delivery for diseases of the oral mucosa. We identify those mucosal diseases currently being treated, the challenges that must be overcome and the potential of novel therapies. Novel biological therapies such as macromolecular biological drugs, peptides and gene therapy may be of value in the treatment of many chronic oral conditions and thus in oral medicine if their delivery can be optimized.